Diseases of the vascular vessels are among the most frequent diseases with fatal outcomes. In particular these include coronary infarction caused by diseases of the coronary vessels. If arteriosclerotic plaque causes an occlusion of coronary vessels, these symptoms are generally treated using Percutaneous Transluminal Coronary Angioplasty (PCTA). The constricted points of the coronary vessels are expanded in such cases with a balloon catheter. However clinical studies have shown that with very many patients a restenosis occurs, in some cases these types of restenosis have occurred in 50% of the patients. High-frequency rotablation angioplasty has been known as an alternative method for a number of years, which can be used advantageously, especially for fibrotic or calcified or extensive stenoses.
To reduce the danger of the formation of restenoses, coronary atherectomy is used in order to achieve a recanalization of stenosized coronary arteries through “debulking”. The device for performing the atherectomy is a catheter system with a metal housing which the actual cutting apparatus, referred to as the cutter, is located. The cutter, consisting of conically ground knives, is connected via a flexible connection to a motor outside the patient. The cutting knife is driven by this motor at a speed of 1500-2000 rpm. On one side of the metal housing a balloon is mounted on the contralateral side is a window. In atherectomy the balloon is inflated and thereby the openings and the knife are pushed into the plaque. The rotating knife can now be push forwards from outside against the tip of the atherectomy housing. This cuts out the plaque and the plaque material is pushed onto the tip of the atherectomy device. The balloon is then deflated, the atherectomy device rotated a little, so that the window shows the plaque in another direction, and the process is repeated. An atherectomy device is known from U.S. Pat. No. 5,895,402.
In DE 10 2004 008 370 A1 a catheter with an integrated OCT sensor for use in blood vessels has been proposed, through which the image display in the local area of the restenosis is improved.
A medical examination and treatment system has been proposed by US 2005/0101859 A1 which combines the OCT and IVUS imaging methods in one device. This enables overlaid 2D image recordings to be created, with the OCT image element being used for the local area and the IVUS image element for the remote area.
A medical examination and/or treatment system is known from US 2005/0113685 A1, in which the imaging methods OCT and IVUS are combined in one catheter, which is also provided with a position sensor. 3D images can be created by means of the information recorded by the position sensor.
The factor common to all known solutions however is that they only resolve individual problems in each case, it has not however been possible thus far to integrate the conventional catheter in an optimum way into the medical workflow.